Before reading any further, please answer the questions in the following quiz. It is meant, like everything else in this book, for your good and to help you fight cancer. If you read past this quiz before taking it, the quiz would be totally meaningless.
This test is not scientifically proven accurate. It is strictly a personal opinion after talking with many cancer patients as well as professionals. The questions have been reviewed by three teams of doctors, psychiatrists and psychologists in Kansas City, at Memorial Sloan-Kettering and at the National Cancer Institute. It is meant to enable you to assess your mental attitude and thus to help you successfully fight your disease.
In answering the questions, remember you are doing this for yourself. No one else ever need see your answers. Do not put down what you think you should say, put down what you honestly feel. Do not try to figure out hidden meanings. Answer each question quickly, as if it were aksed you in conversation.
Type of Cancer Type of Cell Date Diagnosed Check only: Treatment Treatment Received Proposed Surgery ________ ________ Chemotherapy ________ ________ Radiation ________ ________ Immunization ________ ________ Hyperthermia ________ ________ Hormones ________ ________ Psychotherapy ________ ________ 1. I feel that I have had more than my share of bad things happen to me. ___ True ___ Unsure ___ Untrue 2. I am happy with my life and would like it to continue as it has been. ___ True ___ Unsure ___ Untrue 3. I believe my cancer will get the best of me. ___ True ___ Unsure ___ Untrue 4. I would do anything a nurse told me to do without questioning her. ___ True ___ Unsure ___ Untrue 5. I have full faith in my doctor. ___ True ___ Unsure ___ Untrue 6. I believe the treatment I am receiving will successfully treat me. ___ True ___ Unsure ___ Untrue 7. If I were told to have an X-ray similar to one taken the previous day, I would do it without question. ___ True ___ Unsure ___ Untrue 8. I do not want to discuss my cancer with my family. ___ True ___ Unsure ___ Untrue 9. I do not want to discuss my cancer with my friends. ___ True ___ Unsure ___ Untrue 10. If I had a trip, business meeting or other important occasion planned, I would postpone a doctor's appointment or treatment. ___ True ___ Unsure ___ Untrue 11. There are certain treatments I would refuse even if the doctor said it was necessary. ___ True ___ Unsure ___ Untrue 12. I believe I can beat cancer without the help of my doctor. ___ True ___ Unsure ___ Untrue 13. If my doctor recommended a treatment I didn't like, I might try an alternative treatment such as Laetril. ___ True ___ Unsure ___ Untrue 14. I prefer to know as little as possible about my treatments. ___ True ___ Unsure ___ Untrue 15. I would not question my doctor or in any way hurt his feelings. ___ True ___ Unsure ___ Untrue 16. I feel so nervous much of the time that I can't think very well. ___ True ___ Unsure ___ Untrue 17. I feel so depressed most of the time that the future looks black to me. ___ True ___ Unsure ___ Untrue 18. I have had serious emotional problems in the past that are now kicking up again. ___ True ___ Unsure ___ Untrue
You are finished with the questions. Now take a blank sheet of paper and score your results. If the type of cancer is blank or unknown, score 10 points. If the type of cell is blank or unknown, score 5 points.
Under treatment received, if no treatment has been received, score 10 points if diagnosed 60 days ago and 5 points if diagnosed 30 days ago. If currently malignant and no treatment is being received or proposed, score 10 points.
1. 5 True 2 Unsure 2. 2 Unsure 10 Untrue 3. 15 True 2 Unsure 4. 5 True 2 Unsure 5. 2 Unsure 5 Untrue 6. 2 Unsure 5 Untrue 7. 5 True 2 Unsure 8. 5 True 2 Unsure 9. 5 True 2 Unsure 10. 5 True 2 Unsure 11. 10 True 2 Unsure 12. 15 True 2 Unsure 13. 5 True 2 Unsure 14. 5 True 2 Unsure 15. 10 True 2 Unsure 16. 5 True 2 Unsure 17. 5 True 2 Unsure 18. 5 True 2 Unsure Add 5 points for 5 or more "unsure."
Total all your points. A score of 25 or less indicates your attitude is favorable. A score above 25 indicates that you should consider help. The first step is to get recommendations. Talk to your doctor, clergyman, family or friends to suggest a psychiatrist, psychologist or other person who is experienced in counseling cancer patients. Arrange a consultation and be certain you have a good rapport with and confidence in the person. Follow the program they advise, especially as it relates to working with your medical doctors and cooperating in your treatments.
If you scored badly, don't assume that it doesn't apply to you or, now that you know the answers, you will change. Questions are merely indicative of the fundamentals and are from more than 100 that could have been used.
Let's discuss the questions individually and the logic behind each. Not only might you understand some apsects that cancer specialists feel give a better chance of success, but you may pick up specific ideas you had not thought of to help yourself fight cancer.
On the type of cancer and type of cell, if you left either blank or don't know, it could indicate that you lack interest and are failing to take your cancer seriously or do not desire to educate yourself. Either of these are unfavorable signs. I have talked with people who do not know whether they had lung, colon or pancreas cancer. Their doctor told them they were malignant, and they did not want to know any more. This is a form of denial, as if you buried your head in the sand, it might go away. The type of cell is important to know because you should understand as much as possible about your disease to cooperate with your physician in treatments. It is more technical than the type of cancer, so it only scores 5 points instead of 10.
Occasionally, the primary (site of orgin) cannot be found. If this is after looking at all the areas from which the cell could have orginated without success along with qualified second opinions, it is possible the prognosis is better than many known primaries. However, cancer cannot be efficiently and simply treated with maximum agressiveness without knowing the specific primary. Therefore, every reasonable effort should be made to locate the primary. After you have exhausted all second opinions locally without success or agreement, you should suggest to your pathologist that he send your slides to the Armed Forces Institute of Pathology in Washington, D.C. Operated by the U.S. government, their services are completely free. They have equipment that is state-of-the-art and often superior to what is available in parts of the U.S. They have an information desk open 24 hours a day at (202) 576-2800.
If no treatment has been received within 30 days of diagnosis, it can indicate you are not recognizing the critical nature of cancer and the fact that it is probably never as treatable as it is right now. Most cancers are treatable at the time they are discovered. If they go untreated properly, at some time in the future whether tomorrow, next month or next year they will be untreatable. If you've let it go 60 days, obviously the situation is more serious.
If you have a malignancy and no treatment is being given or recommended, you are a masochist and intentionally are waiting for it to get worse, or you have not exhausted all your options and are waiting to die. As a California oncologist told me, there are always options for treatments. As long as he had been practicing, he had never seen a patient run out of possibilities for treatment as long as they were alive.
Questions 1 and 2 are two different ways of attempting to determine your subconscious will to live. If you feel that you have more than your share of bad things happen or if you would not like your life to continue as it has, you probably are not fighting as hard as possible to continue living.
Question 3 is one of the two most critical questions on the quiz. It comes from the theory expressed by many oncologists that there is no way to cure a person who thinks they will die from their cancer. If a person thinks they will die, they are right. That is not to say that if a person thinks they will recover, they will, but at least they have a chance. My personal opinion is that if you have answered question 3 true, you need counseling without regard to any other part of the test because subconsciously you have thrown in the towel and only a miracle could save you.
Question 4 is not intended to be derogatory to a nurse. It merely indicates that you are not taking an interest in trying to educate yourself and help your body help the treatments that fight your disease.
A negative reply to question 5 or 6 would indicate that not only don't you believe in your treatment, but you are probably taking the lazy way out by not searching for a qualified doctor who believes he can sucessfully treat you and in whom you have complete confidence.
Question 7 is a subtle way to ask if you believe you are in charge. This could be true of a blood test or anything else. This is your body. You are responsible for it. You should not necessarily have the same test two days in a row, but you should understand why it is needed and not allow anything to be done to you if it is not necessary.
Eight and 9 are critical questions, not only concerned with the successful treatment of your cancer but with the possibility of recurrence. Discussing your cancer is a necessity to vent your feelings and reduce stress. You should be willing to discuss your cancer openly, not incessantly. Failure to openly communicate will drive away your family or friends and eliminate an absolutely necessary ingredient of your support system. This is one factor I recognize most commonly in patients, one that can be most easily corrected because it is based on erroneous assumptions that those who want to help you don't want to be inflicted with your problems. In reality, they want to share your feelings because in this way they can sincerely express their love and devotion for you. We each have a need to be loved and nurtured. When ill, this need increases. Intimacy and affection can play a major role in healing.
Ten, 11, and 13 are a subtle way of asking your order of priorities. If you are anxious to be successfully treated but only if it is convenient for you, then you do not want it enough to give it your best shot. The same question could have been asked in many ways, such as, if you are a smoker, have you quit? To validate the severity of question 10, an oncologist stated he felt that the rhythm of the treatments, the timing, the fact that each treatment is given on schedule could be as important as what drugs are given. Eleven is valued greater because it is the person you have selected to treat you telling you that you need something specific, and you are going against that advice. I have heard patients say they would do anything except take radiation or chemotherapy or have surgery. What they are saying is that their mind is closed and they want to get well but not enough to do something unpleasant or frightening. They definitely won't give recovery their best effort.
Question 12 is the other single most important question. It embodies many unexpressed inferences. Anyone who believes they can beat cancer without the help of their physician is in a very dangerous predicament in my opinion. Some of the things it could imply are that you have no faith in the physician you chose, and therefore that you have no confidence in anything you are doing, including treatments. It may go further and imply that you have no faith in the medical system or in science. You may have an unrealistic confidence or unattainable expectations in spontaneous remission, spiritualism or alternative therapies. These are wonderful when used as an adjunct to orthodox medicine, but they are suicide when used in lieu of medicine.
Question 14 is fairly obvious on the surface. It is believed by many that understanding each treatment and exactly what it does to and for you will enhance that treatment and magnify its benefits. Closing your mind to these potential benefits indicates moderation of your desire to recover.
Number 15 is a great deal like 7 but on a much more direct and critical basis. This is your life. Your doctor is not God. If there is something you want to know, you should ask. If there is something you don't feel is right, you must express yourself. Your physician wants it this way. When a patient says to me that they would rather die than hurt their doctor's feelings, I say they will.
Sixteen, 17 and 18 are straight forward questions that indicate the state of your mental or emotional health. Often, they go unasked by your physician in the haste of meeting an appointment schedule. If nervousness, depression or emotional problems are present, not only can they depress the immune system in helping to fight your cancer or diminish the effects of many common treatments, but they can occupy your mind and hinder you from applying all your energy toward recovery.
The addition of 5 points for 5 or more unsure answers is based on the idea that strong willed, decisive or determined people have a better chance of beating cancer. To put it in reverse, the wishy-washy, sweet, mild-mannered person does not have as good a chance. By saying you are not sure of your answer to 5 or more questions could indicate you fall in this latter category.
None of these factors are indisputable. There are exceptions. Also, none of your feelings on any subject are irreversible. However, the goal of this quiz is not to get you to change your opinion on any single question. It is to find out your attitude as it relates to being receptive to successful treatments for your cancer. If it is good, marvelous. Cooperate with your physician and let's get on with fighting cancer. If it is on the wrong side of 25, which in and of itself is no magic number but merely an indication, let's do something about it. Talk to your doctor, your clergyman, your family or friends to get the recommendation of a counselor who is experienced in working with a cancer patient. It is another thing that can improve your percentages.